Kamran Justin Azad, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME135792 Issued in FL

Practice address

954 S Orlando Ave Ste 100
Winter Park, FL 32789-4849

Phone

(407) 848-3400

Fax

(407) 602-0901

NPI assigned

Jul 17, 2011

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1310860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1487942009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8469 NEMOURS PKWY",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328277753",
            "telephone_number": "914-806-0653"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 S ORLANDO AVE STE 100",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327894849",
            "telephone_number": "407-848-3400",
            "fax_number": "407-602-0901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZAD",
        "first_name": "KAMRAN",
        "middle_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-17",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "NY",
            "license": "390200000X",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME135792",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "A128991",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Grace Manzo Bacani, PT

• Plastic Surgery Physician in Winter Park, FL
• Providers in Winter Park, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.